What do I mean by design? To quote Joan Osburn, who runs Osburn Design, a well-known architecture and design firm in San Francisco, with her husband Steve, “design is not decoration.” Design to me is a philosophy and an intentionality behind creating things, be they physical structures, gadgets, websites or services, that translate into an optimal user-experience. Optimal, in turn, has elements of both functionality and beauty i.e., (1) were you able to do what you needed to do and, (2) did you enjoy doing it?

Why do I fly Virgin USA or Jet Blue and why do I use a Mac? I can get from point A to point B on a million airlines and I can buy any number of personal computers. But I expect more than functionality, I expect an optimal user experience. And this guides my choices. Thankfully in the world of computers and airlines, I get to reward companies with my hard-earned money for giving me products and services that put my needs and my sensibilities first.
In healthcare, it’s the opposite. We pay, and we pay dearly, for the opposite of an optimal experience: in many cases the product or service does not even meet the functional requirement and let’s not even talk about whether it provides a beautiful or pleasing experience, we are so far off the map there.

But today is Thanksgiving, so I want to give thanks and pay homage to the individuals and companies who get it. I hope you’ll follow these links and engage in the conversation. Healthcare is serious and personal, it’s about life and death, and it will take more than cosmetic surgery to fix. But change and innovation, the adrenaline behind the Health 2.0 movement, must start and end with the user-experience (a.k.a. us) or who are we doing all this for?

And the nominees are:

Emmi Solutions
creates web-based communication tools to engage and educate patients in
a personal, straightforward and conversational manner. I saw Michelle
Sobel speak at the Information Therapy Conference last month and was sold. Michelle was a semiotics major at Brown and designed the video game You Don’t Know Jack in the 90s. She is married to David Sobel, a urologist.

Michelle tells a great story about the language on the labels of pill bottles. So you’ve seen this before: “Take 2 tablets twice a day, PO.” In
a health literacy study, a bunch of people were asked to read this
aloud. More than 95% were correctly able to. Then the same people were
asked to take out the number of pills that this instruction
corresponded to. Only 40-some odd percent took out the correct number
of pills. Michelle says this is not about intelligence, it’s about
clear communication and understandable, non-jargony language in
healthcare. So she advises her clients to phrase the instruction like
this instead: “Take 2 tablets in the morning and 2 tablets at night.” Simple. Done.

Renaissance Health is
a prototype for a medical practice that puts the patient first in all
aspects: from the design of its actual office to the web-based services
it offers to the personalized care plans and attentive follow-up.
Founder Rushika Fernandopulle has been working on redesigning
healthcare for many years. When I visited Renaissance Health in Boston
a few years ago, the first thing I noticed was a beautiful
glass-enclosed conference room with comfortable chairs. I didn’t see
the usual check-in counter manned by frenetic staff against a backdrop
of messy charts and papers. Rushika said, “we wanted to show our belief
in transparency and collaboration.” Design spoke louder than words.

Amy Tenderich who writes Diabetes Mine,
is a blogger, journalist, diabetic, and moderated one of the most
popular panels at the September Health 2.0 conference. Look for her
again in March. Her open-letter to Steve Jobs ,about
why glucose pumps and other medical devices needed to be designed with
the same level of taste, customer focus and creativity as Ipods, drew
tons of attention. Now we just need Steve Jobs to come speak at our
September event and answer Amy in person.

37 Signals is the development team that brought us Basecamp and Highrise. Their manifesto, Getting Real,
has 96 essays on what they call a “smaller, faster, better way to build
software.” Their common sense, no-frills approach is desperately needed
in healthcare IT. Among their tenets:

– build software for yourself: start by trying to solve your own problems

– write stories not details: when explaining a new feature don’t use
technical jargon, explain it through a quick story, using normal, human
language

– interface first: design is what the user sees, ask does it make
sense, is it easy to use, does it solve the problem at hand; program
the backend later

– avoid preferences: Use your expertise to choose the best path.
Customers shouldn’t have to think about every nitty gritty option —
don’t put that burden on them when it should be your responsibility

Refreshing, right? Organized Wisdom
says they hand this book out to all their developers. I did the same on
a Health 2.0 project I worked on this spring. Will someone please
forward the Getting Real link to the HIMSS mailing list?

The company that did Kaiser’s latest Thrive AD campaign, Campbell-Ewald, out of Detroit. Yes, Detroit. But read the copy on their landing page:

“There is no substitute for industrial-strength creativity. There
is no easy route to brilliance. You learn these kinds of things in a
city like Detroit. Where determination and heart win out over smoke and
mirrors.”

And they did this ad for Kaiser with Bob Dylan’s, The times they are a’changing
with the message “Be Your Own Cause.” I think it’s pretty incredible.
And it’s lovely to say the words “pretty incredible” in a healthcare
context. We need lots more occasions to cheer.

So to everyone in healthcare wondering why consumers aren’t flocking
to your product or service, and this goes for doctors, hospital
administrators, policy makers, technologists and health plans, just
take a seat across from yourself and ask if you would buy what you’re
selling. And if the answer is no, as Alec Baldwin said in Glengarry
Glen Ross, “Put that coffee down. Coffee is for closers.”